Table CDR62753 Colorectal Cancer Screening/结直肠癌筛查
ID Type Description_en Description_zh
w1 Word Biennial 每2年一次
w2 Word Disclaimer ​免责声明
w3 Word Site 研究中心
w4 Word RCTs 随机对照试验
w5 Word Fair 一般
w6 Word Poor 差
w7 Word Sigmoidoscopy 乙状结肠镜
w8 Word Denmark 丹麦
w9 Word Minnesota 明尼苏达
w10 Word Unknown 不明
w11 Word Good 佳
w12 Word Screened 筛查组
w13 Word Consistency 一致性
w14 Word Control 对照组
w15 Word Annual 每年一次
w16 Word Colonoscopy 结肠镜
w17 Word Sweden 瑞典
w18 Word Population Size 人数
w19 Word Internal Validity 内部效度
w20 Word Unrehydrated: 1.0% 非再水化：1.0%
w21 Word Study Design 研究设计
w22 Word CT Colonography CT结肠成像
w23 Word Screening Intervention 筛查干预
w24 Word United Kingdom 英国
w25 Word Case-control studies 病例对照研究
w26 Word Unrehydrated: 2.1% 非再水化：2.1%
w27 Word FOBT/ Sigmoidoscopy FOBT/乙状结肠镜
w28 Word Testing Interval 检测间隔
w29 Word Unrehydrated: 2.4% 非再水化：2.4%
w30 Word Immunochemical FOBT 免疫化学FOBT
w31 Word Unrehydrated: 1.9% 非再水化：1.9%
w32 Word No effect 无效果
w33 Word Rehydrated: 9.8% 再水化：9.8%
w34 Word Rehydrated: 5.8% 再水化：5.8%
w35 Word Barium Enema 钡灌肠
w36 Word External Validity 外部效度
p1 Phrase Digital Rectal Examination 直肠指检
p2 Phrase Levels of Evidence ​证据等级
p3 Phrase Studies in progress 正在进展中的研究
p4 Phrase Reviewers and Updates ​审核人与更新
p5 Phrase Relative Mortality Reduction 相对死亡率降幅
p6 Phrase Randomized controlled studies 随机对照研究
p7 Phrase Digital Rectal Exam 直肠指检
p8 Phrase Evidence of Harms 危害证据
p9 Phrase Magnitude of Effects 效应强度
p10 Phrase Positivity Rate (%) 阳性率（%）
p11 Phrase Fecal Occult Blood Test 便潜血检查
p12 Phrase Colorectal Cancer (PDQ®): Screening 结直肠癌（PDQ®）：筛查​
p13 Phrase N/A = not available N/A=不可用
p14 Phrase Computed Tomographic (CT) Colonography 计算机断层扫描（CT）结肠成像
p15 Phrase Stool DNA Mutation Tests 便DNA突变检测
p16 Phrase Ecologic and descriptive studies 生态学与描述性研究
p17 Phrase Fecal Occult Blood Test (FOBT) 便潜血检查（FOBT）
p18 Phrase Fecal Occult Blood Testing (FOBT) 便潜血检查（FOBT）
p19 Phrase About 60%–70% for left colon 对左半结肠约60%-70%
p20 Phrase be discussed at a meeting, ​开会讨论，
p21 Phrase Case-control studies, RCTs in progress 病例对照研究，正在进行中的RCT
p22 Phrase RCT = randomized controlled trial RCT=随机对照试验
p23 Phrase Evidence about lesion detection rate 病变检出率证据
p24 Phrase Evidence about colorectal cancer reduction 减少结直肠癌的证据
p25 Phrase Combination of FOBT and Flexible Sigmoidoscopy FOBT联合软式乙状结肠镜
p26 Phrase Evidence about colorectal cancer mortality reduction 关于结直肠癌死亡率降低的证据
p27 Phrase The primary endpoint was CRC-specific mortality 主要终点为CRC相关死亡率
p28 Phrase Nearly 92% of tests were rehydrated 近92%的检查为再水化检查
p29 Phrase Specificity declined from 97.8% to 96% 特异性从97.8%降低到96%
p30 Phrase Magnitude of Effects on Surrogate Endpoints 对间接终点的效应强度
p31 Phrase Attendance in this study was 65% 该研究出勤率为65%
p32 Phrase Newer FOBTs: Nonrandomized Controlled Trial Evidence 新型FOBT：来自非随机对照试验的证据
p33 Phrase Virtual Colonoscopy (Computed Tomographic [CT] Colonography) 虚拟结肠镜（计算机断层[CT]结肠成像）
p34 Phrase Results were summarized in two systematic reviews 两篇系统性综述总结了这些试验的结果
p35 Phrase Extracolonic abnormalities are common in CT colonography ​CT结肠成像中常可见结肠外异常病变
p36 Phrase iFOBT detects >60% and ≤90% of CRCs iFOBT对CRC的检出率＞60%且≤90%
p37 Phrase There was no effect on all-cause mortality 但筛查不影响全因死亡率
p38 Phrase Detection of DNA Mutations in the Stool 粪便DNA突变检测
p39 Phrase Follow-up ranged from 6 to 13 years 随访时间为6-13年
p40 Phrase Specificity was 86% and PPV was 23% 特异性为86%，PPV为23%
s1 Sentence Sensitivity and specificity were calculated at various cut-points 计算不同阈值的敏感性和特异性
s2 Sentence The flexible fiberoptic sigmoidoscope was introduced in 1969 ​软式光纤乙状结肠镜于1969年问世
s3 Sentence Increasing sensitivity entailed adjusting cut-points to decrease specificity 调整阈值增加敏感性的同时伴随着特异性降低
s4 Sentence The serious complication rate of colonoscopy was 0.5% 结肠镜的严重并发症发生率为0.5%
s5 Sentence A positive FS or FOBT qualified for colonoscopy 软式乙状结肠镜或FOBT检查结果为阳性则需行结肠镜
s6 Sentence The preferred citation for this PDQ summary is: ​关于PDQ总结的较佳引用方法为：
s7 Sentence The incidence is higher in men than in women 男性CRC发病率高于女性
s8 Sentence About 60%–70% for left colon; uncertain for right colon 对左半结肠约60%-70%，对右半结肠不确定
s9 Sentence These images simulate the effect of a conventional colonoscopy 这些图像模拟传统结肠镜的作用
s10 Sentence The rate of complications may increase among older persons 老年人的不良事件发生率可能增加
s11 Sentence The 60 cm flexible sigmoidoscope became available in 1976 1976年1500px软式乙状结肠镜上市
s12 Sentence Billing claims were used to assess exposure to previous colonoscopy 使用费用理赔评估既往结肠镜检查情况
s13 Sentence replace or update an existing article that is already cited ​替换或更新目前引用的文章
s14 Sentence Forty-one cases of CRC were detected (0.3% of screened individuals) 共检出41例CRC（占被筛查者的0.3%）
s15 Sentence Barium enema detects about 30%–50% of cancers detected by colonoscopy 钡灌肠癌症的检出率约占结肠镜癌症检出率30%-50%
s16 Sentence This CRC mortality difference emerged after 9 years of follow-up 随访9年后发现CRC死亡率差异
s17 Sentence Five sigmoidoscopy screening RCTs have reported incidence and mortality results ​5项乙状结肠镜筛查RCT报道了发病率与死亡率结果
s18 Sentence As expected, higher cut points decrease sensitivity and increase specificity 较高的阈值敏感性降低而特异性增加，与预期相符
s19 Sentence The English trial selects candidates from lists of family practitioners 英国试验选择从家庭医师中选择参与者
s20 Sentence Table 3. Randomized Controlled Screening Trials: Fecal Occult Blood Testing 表3. 随机对照筛查试验：便潜血检查
s21 Sentence There are several concerns from this study, including the following: 该研究仍有一些问题，包括：
s22 Sentence Controls were selected from persons who did not die of CRC 对照组为未死于CRC的患者
s23 Sentence About 45% decrease in detection rate of cancers compared with colonoscopy 与结肠镜相比，癌症检出率降低约45%
s24 Sentence CT colonography may have similar sensitivity to colonoscopy in certain centers 某些中心CT结肠成像的敏感性与结肠镜相似
s25 Sentence CRC incidence and overall mortality were virtually identical in both arms 两组的CRC发病率与全因死亡率基本相同
s26 Sentence These high-risk groups account for about a quarter of all CRCs 这些高危人群约占所有CRC患者的四分之一
s27 Sentence Screening was done using the gFOBT Hemoccult-II test after dietary restriction 筛查方法为禁食后行gFOBT Hemoccult-II检查
s28 Sentence Data from randomized controlled trials (RCT) are summarized in Table 3 来自随机对照试验（RCT）的数据总结见表3​
s29 Sentence Cross-sectional study in which iFOBT is administered to persons receiving colonoscopy 对接受结肠镜检查患者的iFOBT横断面研究
s30 Sentence For more information from the NCI, please write to this address: ​如您需从NCI处了解更多信息，请写信至下列地址：
s31 Sentence The predominant age range of participants was 50 to 66 years 参与者多数在50-66岁之间
s32 Sentence Data were collected about demographics, risk factors, and previous screening examinations 搜集的数据包括人口统计学资料、危险因素、既往筛查情况等
s33 Sentence The immunochemical FOBT (iFOBT) was developed to detect intact human hemoglobin ​免疫化学法FOBT（iFOBT）能检测完整的人血红蛋白
s34 Sentence Sigmoidoscopy can also cause perforation and bleeding, although this is rare 乙状结肠镜有穿孔与出血的并发症，尽管较为罕见
s35 Sentence About 3% of patients with no distal adenomas have advanced proximal neoplasia 约有3%无远端腺瘤的患者有近端异型增生的腺瘤
s36 Sentence One-half of those with advanced proximal neoplasia, however, had no distal adenomas 检出高级别近端肿瘤的参与者中，半数无远端腺瘤
s37 Sentence According to colonoscopy records, the cecum was reached 91% of the time 根据结肠镜记录，91%的检查达到回盲部
s38 Sentence Sensitivities were higher for the detection of CRC and lower for adenomas 检出CRC的敏感性较高，检出腺瘤的敏感性较低
s39 Sentence Because there are no RCTs of colonoscopy, evidence of benefit is indirect ​因缺乏结肠镜RCT，获益证据均为间接性
s40 Sentence Some case-control results are available. One RCT of colonoscopy has been initiated 一些病例对照研究结果可供参考，现在一项结肠镜RCT已经启动
s41 Sentence Combined, the two groups account for no more than 6% of CRCs 患有这两种疾病之一的人群占CRC总患病人群比例不超过6%
s42 Sentence No difference in diagnostic yield between sigmoidoscopy + FOBT vs. sigmoidoscopy alone 乙状结肠镜+FOBT与单独行乙状结肠镜对诊断的意义无差异
s43 Sentence Table 1. Effect of Screening Intervention on Reducing Mortality from Colorectal Cancer 表1. 筛查干预对降低结直肠癌死亡率的作用
s44 Sentence Sixteen percent of people had an extracolonic finding that required further evaluation 16%的参与者有结肠外异常发现，需要进一步评估
s45 Sentence Flat lesions may play a role in the phenomenon of missed cancers 扁平状病变在癌症漏诊中可能起重要影响
s46 Sentence There was no clear evidence for superiority of either gFOBT or iFOBT 没有明确证据支持gFOBT或iFOBT优于另一种检测
s47 Sentence Generally, iFOBT testing is more sensitive for cancers than for benign neoplasias 一般地，iFOBT对癌症的敏感性高于对良性肿瘤的敏感性
s48 Sentence Both of these estimates of cost are higher than previous studies have found 这两项研究的成本估计值均高于既往研究
s49 Sentence Adenomas were found in 2,208 participants (17%), and 545 (4.2%) had high-risk adenomas 共2,208例参与者发现息肉（17%），545例（4.2%）参与者发现高危腺瘤
s50 Sentence Expert-reviewed information summary about tests used to detect or screen for colorectal cancer 关于结直肠癌检测或筛查的专家审核信息
s51 Sentence A study of colonoscopy in women compared the yield of sigmoidoscopy versus colonoscopy 一项研究对女性参与者行结肠镜检查，对比了乙状结肠镜与结肠镜的作用
s52 Sentence There is a threefold increase in this rate in patients with distal adenomas 有远端腺瘤的患者近端异型增生腺瘤的发生率增加至3倍
s53 Sentence For right-sided lesions, however, the OR of 0.99 indicated virtually no mortality reduction 但对于右半结肠病变，OR为0.99，提示并未降低死亡率
s54 Sentence CT colonography was performed immediately prior to colonoscopy, and these findings required further evaluation 该研究中，CT结肠成像后立即进行结肠镜检查，这些异常结果需要进行进一步评估
s55 Sentence The disease-specific mortality rate ratio associated with screening was 0.87 (0.78–0.97; P = .01) 与筛查相关的疾病所致死亡率比值为0.87（0.78-0.97；P=0.01）
s56 Sentence It is unstated to what extent the follow-up of these incidental findings benefited patients 该研究并未说明对这些偶然发现进行随访是否让患者获益
s57 Sentence The overall screening compliance rate was 70%, and 47.2% of participants completed all screenings 整体筛查依从率为70%，47.2%的参与者完成了全部筛查
s58 Sentence Harms are associated with the various modalities used to screen for colorectal cancer (CRC) 不同的结直肠癌（CRC）筛查方法均存在一定程度危害
s59 Sentence The Swedish trial is a targeted study for individuals aged 60 to 64 years 瑞典试验为对于60-64岁人群的靶向研究
s60 Sentence CT colonography was performed immediately prior to colonoscopy and these findings required further evaluation 该研究中，CT结肠成像后立即进行结肠镜检查，这些异常结果需要进行进一步评估
s61 Sentence Board members review recently published articles each month to determine whether an article should: ​编委会成员每月审核最新发表的文章，决定文章是否需：
s62 Sentence Advanced neoplasms were found in 24 aspirin users (10.3%) and in 181 nonusers (10.4%) 24例（10.3%）阿司匹林用药者发现高级别上皮内瘤变，181例（10.4%）非阿司匹林用药者发现高级别上皮内瘤变
s63 Sentence The guaiac test identifies peroxidase-like activity that is characteristic of human and nonhuman hemoglobin ​愈创木脂检测可测定过氧化物酶样活性，这是人体和非人体血红蛋白的特征
s64 Sentence The rate ratio for death from all causes was 1.00 (0.98–1.02; P = .79) 全因死亡率比值为1.00（0.98-1.02；P=0.79）
s65 Sentence Another study reported similar sensitivity and specificity in persons with an increased risk of CRC 另一项研究报道了对CRC风险增高人群的敏感性与特异性与上述研究相似
s66 Sentence Among patients with no adenomas distal to the splenic flexure, 2.7% had advanced proximal neoplasia 结肠脾曲远端无腺瘤的参与者中，2.7%有高级别近端肿瘤
s67 Sentence Forty-six percent of those with advanced proximal neoplasms had no distal polyps (hyperplastic or adenomatous) 高级别近端肿瘤患者中46%无远端息肉（增生性或腺瘤性息肉）
s68 Sentence In 2011, authors of one study reported variability of detection rates for proximal serrated polyps ​在2011年，一项研究文章报道了近端锯齿状息肉的检出率差异
s69 Sentence Screening was offered at different frequencies to three different cohorts according to year of birth 根据出生年份将筛查组参与者分为3个小组，每个小组接受不同频次的筛查
s70 Sentence Examination of the rectum and sigmoid colon during colonoscopy was defined as a surrogate for sigmoidoscopy 乙状结肠镜可取代结肠镜进行直肠与乙状结肠的检查
s71 Sentence There are no strong direct data to determine frequency of screening tests in programs of screening ​关于筛查项目中的筛查频率，并无强有效的直接数据
s72 Sentence It would be extremely useful to assess right side versus left side differences in a RCT 进行RCT对比右半结肠与左半结肠的检查差异十分重要
s73 Sentence Table 2. Effect of Screening Intervention on Surrogate Endpoints (e.g., Stage at Diagnosis and Adenoma Detection) 表2. 筛查干预对间接终点（例如诊断时的分期和腺瘤监测）的作用
s74 Sentence The extent to which any patients benefited from the detection of extracolonic findings is not clear 结肠外异常检查让患者受益的程度不甚明确
s75 Sentence Patients who received both CTC and optical colonoscopy preferred CTC to optical colonoscopy (290 vs 175) 即接受CTC也接受结肠镜检查的患者更倾向于CTC（分别290例与175例）
s76 Sentence Neither of these studies examined the effect of extracolonic findings on patient anxiety and psychological function 这两项研究均未评估结肠外异常对患者焦虑与心理状态的影响
s77 Sentence The information in these summaries should not be used as a basis for insurance reimbursement determinations ​总结中信息不可用于制定保险报销决策
s78 Sentence There were no serious complications after FS, but there were six perforations after therapeutic colonoscopy (1:336) 软式乙状结肠镜检查后未发生严重并发症，但结肠镜治疗后6例患者出现穿孔（1：336）
s79 Sentence Some studies have assessed how well virtual colonoscopy can detect colorectal polyps without a laxative prep 一些研究评估了不经肠道准备的情况下，虚拟结肠镜检出结直肠息肉的作用
s80 Sentence It is possible that poor prep or incomplete mucosal inspection caused important lesions to be missed 另一个可能的原因是肠道准备欠佳，或粘膜检查不全面，导致漏诊了重要病变
s81 Sentence Together the trials enrolled 166,000 participants in the screened groups and 250,000 participants in the control groups 这些试验总计有166,000例参与者被分入筛查组，250,000例参与者被分入对照组
s82 Sentence Updated statistics with estimated new cases and deaths for 2014 (cited American Cancer Society as reference 2) 更新2014年的新发病例与死亡病例统计数据估计值（引用美国癌症协会参考文献2）
s83 Sentence Limiting screening or early cancer detection to only these high-risk groups would miss the majority of CRCs 仅对这些高危人群进行筛查或早期癌症检测将漏诊多数肿瘤病变
s84 Sentence FIT alone resulted in a sensitivity of 58.3% and a specificity of 94.5% for proximal cancer diagnosis 仅FIT对近端结肠癌的诊断敏感性为58.3%，特异性与94.5%
s85 Sentence The smaller study found no important lesions from evaluation, at a cost of $248 per person screened 小型研究中，进一步的评估并未发现重要病变，每例患者的筛查支出为248美元
s86 Sentence Participants in the control group were not contacted and were unaware they were part of the trial 该试验不联系对照组参与者，这些参与者并不知晓参与试验
s87 Sentence Another study utilized low fiber diet, orally ingested contrast, and 'electronic cleansing', a process that subtracts tagged feces 另一项研究使用了低纤维饮食、口服对比剂和“电子清洁”过程对粪便进行标记，处理过程中可剪去粪便影
s88 Sentence On initial (prevalence) examinations, from 1% to 5% of unselected persons tested with gFOBT have positive test results 初步（患病率）检查发现行gFOBT的未经选择的被检查者中1%-5%检查结果为阳性
s89 Sentence Most, but not all, lesions found by CTC and not by OC were followed up with repeat OC CTC而非OC发现的病变中多数（但并非全部）随访使用OC进行
s90 Sentence A case-control study assessed CRC reduction (not CRC mortality reduction) in the right side versus the left side 一项病例对照研究评估了右半结肠与左半结肠CRC减少情况（而非CRC死亡率降低情况）
s91 Sentence The OR for the association between complete colonoscopy and left-sided lesions was 0.33, suggesting a substantial mortality reduction 全面结肠镜检查与左半结肠病变之间相关性的OR为0.33，提示死亡率显著降低
s92 Sentence In 2,885 veterans (97% male; mean age 63 years), the prevalence of advanced adenoma at colonoscopy was 10.6% 2,885例退伍军人（97%男性，平均年龄63岁）中结肠镜检出的高级别腺瘤发病率为10.6%
s93 Sentence Preliminary studies of several commercially developed iFOBT tests define their sensitivity and specificity compared with concurrently performed colonoscopy 一些市售iFOBT检测法的初步研究比较了该方法与结肠镜相比的敏感性与特异性
s94 Sentence A positive FS was defined as a finding of any neoplasia or any polyp at least 10 mm 软式乙状结肠镜结果阳性定义为发现任何肿瘤或直径大于等于10 mm的任何息肉
s95 Sentence In this study, the sensitivity of OC could not be determined because it was done in an unblinded manner 该研究未设盲，故无法确定OC的敏感性
s96 Sentence These studies also examine these outcomes for different cut points, and the benefit of multiple versus single stool samples 这些研究也评估了不同阈值的结局，及多次标本采集检测相较于单次粪便标本采集的获益
s97 Sentence Any comments or questions about the summary content should be submitted to Cancer.gov through the Web site's Contact Form ​如您对本总结有任何疑问或评论，请填写Cancer.gov页面上的联系表并提交
s98 Sentence The molecular genetic changes that are associated with the development of colorectal adenomas and carcinoma have been well characterized 分子遗传学变化与结直肠腺瘤、结直肠癌发生发展的相关性已经得到充分研究
s99 Sentence There was, however, no difference in all-cause mortality between the screened and control groups (RR, 1.00; 95% CI, 0.99–1.02) 但筛查组与对照组的全因死亡率无差异（RR，1.00；95%CI，0.99-1.02）
s100 Sentence A positive test can lead to further diagnostic procedures that include colonoscopy or double-contrast barium enema plus flexible sigmoidoscopy 假阳性结果可导致进一步的诊断检查，包括结肠镜、钡灌肠双重造影加软式乙状结肠镜等
s101 Sentence Most of these adenomas are polypoid, flat and depressed lesions, which may be somewhat more prevalent than previously recognized 多数腺瘤为息肉样、扁平或凹陷病变，这些病变所占比例可能多于既往认知
s102 Sentence The finding of an adenoma by FS may warrant colonoscopy to evaluate the more proximal portion of the colon 软式乙状结肠镜检查发现息肉后，需行结肠镜检查评估近端结肠情况
s103 Sentence At a median follow-up time of 7.8 years, 60% completed at least one test, and 38% completed all tests 随访时间中位数为7.8年，60%参与者至少完成一次筛查，38%参与者完成全部筛查
s104 Sentence This difference, which was striking and unexpected, might be explained in several possible ways and has been discussed extensively 该差异完全出乎意料，出现该差异的原因可能多种多样，一些文章对此进行过深入讨论
s105 Sentence It also does not detect partly digested human hemoglobin that comes from the upper respiratory or gastrointestinal (GI) tract 同时该方法已不能检测来自上呼吸道或上消化道（GI）的被消化的人血红蛋白
s106 Sentence The rigid instrument can discover 25% of polyps, and the 60 cm scope can find as many as 65% 硬式乙状结肠镜能发现25%的息肉，60 cm软式乙状结肠镜能发现65%的息肉
s107 Sentence One-time use of FOBT differs from the annual or biennial application reported in those studies summarized in Table 1 单次FOBT与这些研究中每年一次或每两年一次肠镜筛查的区别见表1​
s108 Sentence Advanced techniques have been developed to detect several of these gene mutations that have been shed into the stool 一些先进技术已被用于检测排入粪便的几种基因突变
s109 Sentence The advantage of iFOBT over guaiac FOBT (gFOBT) is that it does not detect hemoglobin from nonhuman dietary sources iFOBT与愈创木脂法FOBT（gFOBT）相比，其优势在于iFOBT不会检测出饮食中的非人体血红蛋白
s110 Sentence These models project a reduction in CRC mortality or an increase in life expectancy using currently available screening methodology 这些模型发现使用当前的筛查方法可降低CRC死亡率或延长预期寿命
s111 Sentence In FOBT testing, a person collects stool samples that are analyzed for the presence of small amounts of blood ​FOBT检查采集患者粪便标本，分析是否存在少量红细胞
s112 Sentence Fecal immunochemical tests may vary with regard to numbers of stools tested and cut-off values for a positive result ​便免疫化学法检测结果与检测次数、阳性阈值相关
s113 Sentence In patients who have undergone colonoscopic polypectomy, colonoscopic examination is a more sensitive method of surveillance than double-contrast barium enema 对于结肠镜息肉切除术后患者，以结肠镜检查作为监测方法的敏感性优于钡灌肠双重造影
s114 Sentence Genetic, experimental, and epidemiologic studies suggest that CRC results from complex interactions between inherited susceptibility and environmental or lifestyle factors 遗传学、实验与流行病学研究发现CRC的发生是内在易感性和环境或生活方式等多因素发生复杂的相互作用所致
s115 Sentence It is possible that exams were incomplete and did not reach the cecum even though they were coded as complete 一个可能的原因是检查未行全结肠检查，即未达到回盲部，但确记录全结肠检查
s116 Sentence Detection rates in colonoscopy screening vary with the rate at which the endoscopist examines the colon while withdrawing the scope ​结肠镜筛查的检出率与内镜医师撤结肠镜过程中检查结肠的速度相关
s117 Sentence The latter result could be achieved assuming that all patients with an adenoma in the distal colon undergo complete colonoscopy 假设所有远端结肠腺瘤患者均行全面结肠镜，可得到后一种结果
s118 Sentence Sixty-seven percent completed the first screen, and more than 90% of individuals invited to each subsequent screen underwent FOBT testing 67%的患者完成了初次筛查，接受后续筛查邀请的参与者中超过90%接受了FOBT检测
s119 Sentence Efforts to identify causes led to the hypothesis that adenomatous polyps (adenomas) are precursors for the vast majority of CRCs 为病因的发生产生假说，即腺瘤性息肉（腺瘤）是绝大多数CRC的癌前病变
s120 Sentence If you have questions or comments about this summary, please send them to Cancer.gov through the Web site’s Contact Form ​如您对本总结有任何疑问或评论，请填写Cancer.gov页面上的联系表并提交
s121 Sentence Most indirect evidence is about detection rate of lesions that may be clinically important (like early CRC or advanced adenomas) 多数间接证据与临床上重要的病变检出率相关（例如早期CRC或高级别腺瘤）
s122 Sentence Five controlled clinical trials have been completed or are in progress to evaluate the efficacy of screening utilizing the FOBT 有5项已完成或仍在进行中的对照临床试验评估了使用FOBT进行筛查的有效性
s123 Sentence Because both of these studies were conducted in academic medical centers, the generalizability to other settings is also not clear 因为这两项研究均在学术医学中心进行，故对其他医院的普适性也不明确
s124 Sentence Although there is no RCT to assess reduction of CRC incidence or mortality by colonoscopy, some case-control evidence is available 虽然尚无RCT评估结肠镜可降低CRC发病率或死亡率的作用，但已有一些可参考的病例对照证据
s125 Sentence Note: Separate PDQ summaries on Colorectal Cancer Prevention ; Colon Cancer Treatment ; and Rectal Cancer Treatment are also available 注：关于直肠癌的其他总结，见结直肠癌的预防、结肠癌的治疗与直肠癌的治疗​
s126 Sentence All trials have shown a more favorable stage distribution in the screened population compared with controls (see Table 3 ) 所有试验均显示筛查组人群的分期分布优于对照组（见表3​）
s127 Sentence Deaths from all causes were very similar in the two groups, with a mortality ratio of 1.02 (95% CI, 0.99–1.06) 两组的全因死亡率极为相似，死亡比为1.02（95%CI，0.99-1.06）
s128 Sentence It was estimated that combined screening with one-time FOBT and sigmoidoscopy would detect 75.8% (95% CI, 71.0%–80.6%) of advanced neoplasms 据估计一次FOBT联合乙状结肠镜检查可检出75.8%（95%CI，71.0%-80.6%）高级别瘤变
s129 Sentence From 2006 to 2010, mortality from CRC declined by 2.5% per year in men and 3.0% per year in women 2006-2010年，男性中CRC所致死亡率每年降低2.5%，女性中死亡率每年降低3.0%
s130 Sentence After a median follow-up of 11.8 years, no difference in CRC incidence between the intervention and control groups was observed 随访时间中位数为11.8年，干预组与对照组的CRC发病率无差异
s131 Sentence In women, it ranges from 31.9 per 100,000 per year in Hispanics to 50.3 per 100,000 per year in African Americans 女性CRC发病率最低为西班牙裔，女性的发病率为31.9例每十万人年，最高为非裔美国女性，其发病率为50.3例每十万人年
s132 Sentence Individuals with a positive test result were invited to an examination consisting of a case history, FS, and double-contrast barium enema 向检查结果阳性的患者提供全面检查，包括病史采集、FS、气钡双重造影
s133 Sentence The performance of iFOBT was tested in an ongoing diagnostic study (2005–2009) at 20 internal medicine GI practices in southern Germany 一项持续进行的诊断学研究（2005-2009年）在德国南部20个消化内科中心评估了iFOBT的作用
s134 Sentence Sensitivity and specificity based on subsequent colonoscopy were, respectively, 65.8% and 94.6% for cancer and 27.1% and 95.1% for advanced neoplasm 根据结肠镜结果，判定筛查检出癌症的敏感性与特异性分别为65.8%与94.6%，检出高级别上皮内瘤变的敏感性与特异性分别为27.1%与95.1%
s135 Sentence The combined results showed that trial participants allocated to screening had a 16% lower CRC mortality (RR, 0.84; 95% CI, 0.78–0.90) 联合结果表明筛查组的试验参与者CRC死亡率降低16%（RR，0.84；95%CI，0.78-0.90）
s136 Sentence The term serrated polyp is currently used to include hyperplastic polyps, sessile serrated adenomas, traditional serrated adenomas, and mixed serrated polyps “锯齿状息肉”目前包括增生性息肉、无蒂锯齿状息肉、寻常锯齿状息肉和混合锯齿状息肉
s137 Sentence The clinical significance of these lesions is uncertain, because the natural history is so difficult to learn for any polypoid lesion 这些病变的临床意义不甚明确，因任何息肉状病变的自然病程均很难了解
s138 Sentence It ranges from 46.1 per 100,000 per year in Hispanic men to 66.9 per 100,000 per year in African American men 在男性CRC的发病率最低为西班牙裔，男性的发病率为46.1例每十万人年，最高为非裔美国男性，其发病率为66.9例每十万人年
s139 Sentence FIT plus the finding of advanced neoplasia in the rectosigmoid colon yielded a sensitivity of 62.5% and a specificity of 93% FIT加结肠镜对乙状结肠直肠高级别瘤变的敏感性为62.5%，特异性为93%
s140 Sentence The number of colonoscopies required to detect a single advanced adenoma or cancer increased from 1.9 to 2.3; a 20% increase 检出单个高级别腺瘤或癌症所需进行的结肠镜次数为1.9-2.3次，增加了20%
s141 Sentence There were five deaths within 30 days of surgery for screen-detected CRC or adenoma in a total of 75,253 individuals screened 总计筛查75,253人次，筛查检出的CRC或腺瘤手术后30天内共5例死亡
s142 Sentence Suspected abnormalities involved kidney (34), chest (22), liver (8), ovary (6), renal or splenic arteries (4), retroperitoneum (3), and pancreas (1) 可疑的异常包括肾脏（34）、胸腔（22）、肝脏（8）、卵巢（6）、直肠或脾动脉（4）、腹膜后（3）与胰腺（1）
s143 Sentence Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only ​本总结图像经作者、绘图作者和（或）出版商允许，仅在PDQ总结内使用
s144 Sentence The report contains no discussion on contamination in the control arms of the trials and no information on treatment by stage 该文章并未讨论试验对照组污染问题，也未提供不同分期的治疗信息
s145 Sentence Clinically significant complications requiring medical intervention are rare but can include the following: perforations, bleeding, cardiovascular events, and other adverse events 需医疗干预的有临床意义的并发症较为罕见，包括：穿孔、出血、心血管事件和其他不良事件
s146 Sentence Overall detection rate of adenomas and cancer may be affected by how thoroughly endoscopists search for flat adenomas and flat cancer 腺瘤与癌症的总检出率受到内镜医师检查扁平状腺瘤与扁平状癌的细致度的影响
s147 Sentence There was no difference in diagnosis yield between the FS only and the FS and FOBT groups regarding CRC or high-risk adenoma 单独行软式乙状结肠镜组与乙状结肠镜联合FOBT组的CRC或高危腺瘤诊断率无差异
s148 Sentence About 5% of Americans are expected to develop the disease within their lifetime and about half of those will die from it 约5%的美国人一生中预期将发生CRC，半数患病者将因此病死亡
s149 Sentence The range of follow-up times was from 6 years 7 months to 19 years 5 months, depending on the date of enrollment 随访时间为6年7个月-19年5个月，依入组日期不同而各异
s150 Sentence Furthermore, the trials reported a low positive predictive value (PPV) for the FOBT test, suggesting that most positive tests were false positives 此外，多项试验报道了FOBT检测的阳性预测值较低（PPV），多数阳性结果为假阳性结果
s151 Sentence This study shows that CTC without a laxative prep detects small 1 cm lesions with high sensitivity and is acceptable to patients 该研究显示不经肠道准备的情况下，CTC检出较小的25px病变的敏感性较高，患者接受度较好
s152 Sentence Technical improvements involving both the interpretation methodology, such as three dimensional (3-D) imaging, and bowel preparation are under study in many centers ​很多中心目前在研究分析方法学，例如三维（3D）成像、与肠道准备等技术进展
s153 Sentence Stool samples were thawed within a median of 4 days after arrival at the central laboratory (shipped frozen from the recipient clinics) 患者同意填写关于止痛药与低剂量阿司匹林（预防心血管疾病）的标准问卷
s154 Sentence The particular tagging material used in this study caused about 10% of patients to become nauseated; however, other materials are being assessed 该研究使用的特殊标记物造成约10%患者有恶心反应，目前正在进行其他标记材料的评估
s155 Sentence Nearly 85% of patients with a positive test underwent diagnostic procedures that included colonoscopy or double-contrast barium enema plus flexible sigmoidoscopy (FS) 便潜血阳性的患者中近85%接受了结肠镜、钡灌肠双重造影与软式乙状结肠镜（FS）等诊断操作
s156 Sentence The overall proportion of polyps that are "serrated" is unknown, in part because these lesions have been unappreciated and/or difficult to identify “锯齿状”息肉占所有息肉的总比例仍不明确，部分原因是这些病变曾被忽视和（或）难以鉴别
s157 Sentence A systematic review done through the Cochrane Collaboration examined all CRC screening randomized trials that involved FOBT on more than one occasion Cochrane协作组进行的一项系统性回顾评估了所有纳入至少一次FOBT检测的CRC筛查随机试验
s158 Sentence The trials reported a low positive predictive value for the FOBT, suggesting that more than 80% of all positive tests were false-positives 多项试验报道了FOBT检测的阳性预测值较低（PPV），多数阳性结果为假阳性结果
s159 Sentence Analysis of data from a colonoscopy-based screening program in Warsaw, Poland demonstrated higher rates of advanced neoplasia in men than in women ​对以结肠镜为基础的波兰华沙筛查项目数据进行分析，发现男性中高级别瘤变发生率高于女性
s160 Sentence The flexible sigmoidoscope permits a more complete examination of the distal colon with more acceptable patient tolerance than the older rigid sigmoidoscope 软式乙状结肠镜可对远端结肠进行更全面的检查，但患者的耐受性比硬式乙状结肠镜好
s161 Sentence Flat or difficult-to-detect lesions include "serrated polyps," which may be more common in the right colon than they are in the left ​扁平状或难以检出的病变中包括“锯齿状息肉”，这种病变在右半结肠更为常见
s162 Sentence Some studies have utilized the quantitative ability of iFOBT to consider detection and specificity at various test cut-points for defining a positive test 一些研究使用了iFOBT的定量性能评估了不同阳性阈值的检出率与特异性
s163 Sentence The Danish trial offers screening to a population aged 45 to 75 years who were randomly assigned to a control or study group 丹麦试验则对45-75岁的人群进行筛查，将参与者随机分入对照组或试验组
s164 Sentence A systematic review done through the Cochrane Collaboration examined all CRC screening randomized trials that involved gFOBT testing on more than one occasion ​Cochrane协作组进行的一项系统性回顾评估了所有纳入至少一次gFOBT检测的CRC筛查随机试验
s165 Sentence While the phenomenon of flat neoplasms has been appreciated for years in Japan, it has more recently been described in the United States 尽管日本对扁平状肿瘤已经开展了多年研究，但美国最近才开始描述这种肿瘤
s166 Sentence Thus, it will record blood from ingested meat, upper airway bleeding such as epistaxis, upper gastrointestinal (GI) bleeding, as well as colonic lesions 因此可检测出消化了的肉类、上呼吸道出血（如鼻衄）、上消化道（GI）出血和结肠病变所致出血
s167 Sentence A case-control study reported that routine digital rectal examination was not associated with any statistically significant reduction in mortality from distal rectal cancer 一项病例对照研究报道了常规直肠指检并不显著降高位直肠癌的死亡率
s168 Sentence The design itself did not allow for following patients, thus potentially missing lesions that grow rapidly and would only be seen after follow-up 该设计本身并不包括下列患者，故可能漏诊一些生长过快的病变或只能在后续随访中发现的病变
s169 Sentence More information about contacting us or receiving help with the Cancer.gov Web site can be found on our Contact Us for Help page ​您可以在帮助联系方式页面上找到关于联系方式的更多信息或得到Cancer.gov的帮助
s170 Sentence Colorectal cancer (CRC) is the third most common malignant neoplasm worldwide and the second leading cause of cancer deaths in the United States 结直肠癌（CRC）位列全球最常见恶性肿瘤第三位，列位美国癌症死亡病因第2位
s171 Sentence If colonoscopic screening is performed only in patients with distal polyps, about half the cases of advanced proximal neoplasia will not be detected 如仅对有远端息肉患者进行结肠镜筛查，将疏漏近半数高级别近端肿瘤病例
s172 Sentence Nineteen hundred seventy-nine patients (233 regular low-dose aspirin users and 1,746 never users) were identified in the records for inclusion in the analysis 根据病历，分析中共纳入1979例患者（233例常规服用低剂量阿司匹林，1,746例从未服用阿司匹林）
s173 Sentence At 150 ng/mL the respective sensitivities and specificities were 82.4% and 91.9% for cancer and 53.8% and 95% for any clinically significant neoplasia 阈值为150 ng/mL时，检测癌症的敏感性与特异性分别为82.4%与91.9%，检测有临床意义的肿瘤（癌症与高级别息肉）的敏感性与特异性分别为53.8%与95%
s174 Sentence CTC identified 91% of persons with adenomas 10 mm or larger, but detected fewer (70%) lesions greater than or equal to 8 mm CTC能检出91%的直径大于等于10mm的腺瘤，但对直径大于等于8mm的病变检出率降低（70%）
s175 Sentence After exclusions for health and cognitive reasons, 1,859 patients were offered iFOBT, 1,116 patients adhered to the protocol, and 1,000 patients completed the procedure 排除健康与认知因素后，对1,859例患者进行iFOBT检查，其中1,116例患者依从研究方案，1,000例患者完成了所有流程
s176 Sentence There were no deaths; however, the author reported that collection of 30-day complications data was not systematic; therefore, the data may not be reliable 该筛查项目无死亡事件，但作者指出并未系统采集30天并发症数据，故这些数据可能并不十分可靠
s177 Sentence In addition, the natural history of advanced neoplasia is not known, so its importance as an outcome in studies of detection is not clear 此外，目前尚不明确高级别瘤变的自然病程，故该结局的重要意义仍不确定
s178 Sentence A meta-analysis of all previously reported randomized trials using biennial FOBT showed no overall mortality reduction by gFOBT screening (RR, 1.002; 95% CI, 0.989–1.085) 对所有曾发表的采用每2年一次FOBT筛查的随机试验进行荟萃分析，结果显示gFOBT筛查并不降低全因死亡率（RR，1.002；95%CI，0.989-1.085）
s179 Sentence Deaths from CRC were 252 in the screening group and 300 in the control group, with a mortality ratio of 0.84 (95% CI, 0.71–0.99) 筛查组发生252例CRC死亡，对照组发生300例CRC死亡，死亡比为0.84（95%CI，0.71-0.99）
s180 Sentence It is estimated that there will be 136,830 new cases diagnosed in the United States in 2014 and 50,310 deaths due to this disease 据估计，美国在2014年将有136,830例新发CRC并且50,310患者将因该病死亡
s181 Sentence It is also possible that examination was complete but some right-sided lesions simply grow rapidly and are not detected and treated by periodic colonoscopy 第三个可能的原因是经过了全结肠检查，但一些右半结肠病变生长过快，并未经过定期结肠镜检查和治疗
s182 Sentence The gold standard was the OC, including repeat OC exams for people with lesions found by computed tomographic colonography (CTC) but not by OC 金标准为OC，对CT结肠造影（CTC）而非OC发现的病变重复进行OC检查
s183 Sentence In the meantime, the results of the study mentioned above question what is known about the degree of CRC mortality reduction provided by colonoscopy 与此同时，上述研究的结果提出了结肠镜降低CRC死亡率作用大小的问题
s184 Sentence The age-adjusted mortality rates for men and women are 20.2 per 100,000 per year in men and 14.1 per 100,000 per year in women 男性与女性的年龄别死亡率分别为20.2例和14.1例每十万人年
s185 Sentence Stool samples were collected by patients following iFOBT kit instructions and analyzed by the OC-MICRO analyzer (from the Eiken Chemical Company in Tokyo, Japan) 根据iFOBT试剂盒的说明采集患者便标本，使用OC-MICRO分析仪（日本东京Eiken Chemical Company）分析
s186 Sentence Thus, in this trial, the addition of sigmoidoscopy to FIT did not substantially improve the detection of right-sided colon cancers, compared with FIT alone 故该试验，FIT加乙状结肠镜检查与单独行FIT相比，并不显著增加右半结肠癌的检出率
s187 Sentence Among 1,463 women, cancer was found in one woman and advanced colonic neoplasia in 72 women or 4.9% (about one-half the prevalence compared with men) 在1,463例女性参与者中，发现1例癌症，72例（4.9%）高级别结肠肿瘤（患病率约为男性的一半）
s188 Sentence The larger study found nine cancers from these evaluations, at a partial cost (they did not include all costs) of $98.56 per patient initially screened 大型研究从进一步评估中发现9例癌症，初步筛查每例患者的部分支出为98.56美元（并未计算全部支出）
s189 Sentence This represented a small but statistically insignificant increase in the rate of detection of advanced neoplasia when compared with FS alone (70.3%; 95% CI, 65.2%–75.4%) 与单独行软式乙状结肠镜相比，联合筛查的高级别瘤变检出率略有增加，但具有统计学显著性（70.3%；95%CI，65.2%-75.4%）
s190 Sentence After 18 years of follow-up, the incidence of CRC was reduced by 20% in the annually screened arm and 17% in the biennially screened arm 随访18年发现每年筛查一次组的CRC发病率降低20%，每2年筛查一次组的CRC发病率降低17%
s191 Sentence CRC = colorectal cancer; CT = computed tomography; FOBT = fecal occult blood test; iFOBT = immunochemical fecal occult blood test; N/A = not available CRC=结直肠癌；CT=计算机断层扫描；FOBT=便潜血检查；iFOBT=免疫化学法便潜血检查；N/A=不可用
s192 Sentence Two other studies, one large (n = 2,195) and one small (n = 136) examined the moderate or high importance of extracolonic findings from CTC 另有2项研究评估了CTC发现的结肠外异常的重要性，包括一项大型研究（n=2,195）和一项小型研究（n=136）
s193 Sentence Mathematical models have been constructed to extrapolate the results of screening trials to screening programs for the general population in community health care delivery settings ​一些研究构建了数学模型，将筛查试验的结果推广至社区医疗站普通人群的筛查项目
s194 Sentence Advanced neoplasia was defined as a lesion measuring at least 10 mm in diameter, containing 25% or more villous histology, high-grade dysplasia, or invasive cancer 高级别瘤变定义为直径至少10mm、含有25%或更多绒毛状成分、高级别不典型增生或侵袭性癌
s195 Sentence Because the centers conducting the screening were primarily academic centers and the radiologists and endoscopists were carefully trained, the generalizability of the findings is not clear 因进行筛查的中心主要为学术中心，故放射科医师与内镜医师均接受过详细培训，故这一结果是否具有普适性仍不明确
s196 Sentence Sigmoidoscopy can be an uncomfortable or painful procedure. Women may have more pain during the procedure, which may discourage them from returning for future screening sigmoidoscopies 乙状结肠镜检查会造成患者不适甚至疼痛，在检查过程中女性的疼痛感更甚，导致部分患者不再返回中心接受后续乙状结肠镜筛查
s197 Sentence As part of the National Polyp Study, colonoscopic examination and barium enema were compared in paired surveillance examinations in those who had undergone a prior colonoscopic polypectomy ​美国全国息肉研究项目对比了对结肠镜息肉切除术后患者接受结肠镜或钡灌肠的筛查效果，该对比研究以配对监测形式进行
s198 Sentence Colonoscopy in the previous 10 years was associated with an OR for any CRC of 0.23, for right-sided CRC of 0.44, and for left-sided CRC of 0.16 过去10年内结肠镜检查导致任何CRC的OR为0.23，右半结肠CRC为0.44，左半结肠CRC为0.16
s199 Sentence However, a recent case-control study of colonoscopy raises questions about whether the impact of colonoscopy on right-sided lesions might be different than the impact on left-sided lesions 但最新一项结肠镜病例对照研究提出质疑，认为结肠镜对右半结肠的影响可能与左半结肠不同
s200 Sentence Of those persons with positive test results, approximately 2% to 10% have cancer and approximately 20% to 30% have adenomas, depending on how the test is done 结果为阳性的被检查者中，发现约2%-10%有癌症，约20%-30%有腺瘤，该比例与检测方法相关
s201 Sentence Sixty-nine percent of 681 asymptomatic patients in Minnesota had extracolonic findings, of which 10% were considered to be highly important by the investigators, requiring further medical workup 明尼苏达州一项研究纳入681例无症状患者，其中69%患者有结肠外异常，其中10%被研究者评估为有重要意义，需进一步检查
s202 Sentence The question is of great importance for implementation because the laxative prep required by both conventional colonoscopy and virtual colonoscopy is considered a great disadvantage by patients 这一课题非常重要，因为传统结肠镜和虚拟结肠镜均要求行肠道准备，但患者对肠道准备接受度较低
s203 Sentence Of the 2,180 participants with a positive test, 1,890 (86.7%) underwent a complete diagnostic evaluation with 104 cancers and 305 adenomas of at least 10 mm detected 检查结果为阳性的2,180例参与者中，1,890例（86.7%）进行了全面诊断评估，共发现104例癌症患者和305例直径大于等于10mm的腺瘤患者
s204 Sentence In a study of 1,994 adults (aged 50 years or older) who underwent colonoscopic screening as part of a program sponsored by an employer, 5.6% had advanced neoplasms 一项研究对1,994例成年参与者（年龄大于等于50岁）进行雇主赞助的结肠镜筛查，其中5.6%有高级别瘤变
s205 Sentence On this basis, the approach looks promising but would be improved, if possible, by increased sensitivity (perhaps by increasing the number of DNA markers) and by reduced cost 根据这一结果，DNA检测法似乎前景远大，但仍需改善其敏感性（一种方式是通过增加DNA标志物实现）并降低费用
s206 Sentence Cumulative incidence of CRC was similar in both arms, and the trial reported a RR reduction of 15% in CRC mortality (odds ratio [OR], 0.85; 95% CI, 0.74–0.98) 两组的CRC累积发病率相似，该试验报告CRC死亡率相对风险降低15%（比值比[OR]，0.85；95% CI，0.74–0.98）
s207 Sentence Age-specific incidence and mortality rates show that the vast majority of cases are diagnosed after age 50 years; about 4% of CRCs occur younger than age 50 years 不同年龄组的发病率和死亡率显示绝大多数患者诊断时年龄大于50岁，约4% CRC发生于年龄低于50岁的人群
s208 Sentence Sensitivities for the detection of all neoplasms ranged from 6.2% (specificity 98%) to 83.3% (specificity 98.4%) for gFOBTs and 5.4% (specificity 98.5%) to 62.6% (specificity 94.3%) for iFOBT gFOBT对所有肿瘤的敏感性从6.2%（特异性98%）到83.3%（特异性98.4%），iFOBT对所有肿瘤的敏感性从5.4%（特异性98.5%）到62.6%（特异性94.3%）
s209 Sentence Calculations were based on the most severe pathologic finding from colonoscopy and the highest fecal-hemoglobin concentration measured by iFOBT applied to three stool samples collected prior to the colonoscopy 敏感性与特异性的计算是根据结肠镜上的最重度病理发现和结肠镜前3次标本iFOBT测得的便血红蛋白最高浓度
s210 Sentence Two case-control studies have been reported that evaluate the efficacy of screening sigmoidoscopy in preventing CRC mortality; one study used rigid sigmoidoscopy, and the other used rigid and FS ​两项病例对照研究评估了乙状结肠镜筛查预防CRC死亡的有效性；一项研究使用了硬式乙状结肠镜，另一项研究使用硬式乙状结肠镜与软式乙状结肠镜
s211 Sentence Using a province-wide administrative data base in Ontario, investigators compared cases of persons who had received a diagnosis of CRC from 1996 to 2001 and had died by 2003 研究者使用安大略省的省级管理数据库，评估了1996-2001年之间诊断CRC且2003年之前死亡患者的死因
s212 Sentence While this study does not assess CRC mortality, the results suggest that the magnitude of the right side versus the left side difference may be smaller than previously found 虽然该研究并未评估CRC死亡率，但结果表明结肠镜对右半结肠和左半结肠的作用差异小于此前研究报道的数值
s213 Sentence Virtual colonoscopy (also known as CT colonography or CT pneumocolon) refers to the examination of computer-generated images of the colon constructed from data obtained from an abdominal CT examination ​虚拟结肠镜（也称为CT结肠成像或CT结肠充气造影）指根据腹部CT采集到的数据产生计算机生成的结肠成像
s214 Sentence Stool samples were analyzed using the Magstream 1,000/Hem SP automated system (from Fujirebio Incorporated, Tokyo, Japan), which is based on the HemeSelect system (from Beckman Coulter, Palo Alto, California) 便标本分析使用Magstream 1,000/Hem SP自动系统（日本东京Fujirebio Incorporated），该系统基于HemeSelect系统（加利福尼亚州帕洛阿尔托市Beckman Coulter）
s215 Sentence Participants were aged 50 to 59 years in the Telemark trial, aged 55 to 74 years in PLCO, and aged 55 to 64 years in the other three trials Telemark试验的参与者年龄为50-59岁，PLCO试验参与者为55-74岁，其他3项试验的参与者年龄为55-64岁
s216 Sentence At a cut-point of 100 ng/mL, sensitivity and specificity were, respectively, 88.2% and 89.7% for cancer and 61.5% and 91.4% for any clinically significant neoplasia (cancer and advanced polyps) 阈值为100 ng/mL时，检测癌症的敏感性与特异性分别为88.2%与89.7%，检测有临床意义的肿瘤（癌症与高级别息肉）的敏感性与特异性分别为61.5%与91.4%
s217 Sentence The NORCCAP once-only screening study randomly assigned 20,780 men and women, aged 50 to 64 years, to FS only or a combination of FS and FOBT with FlexSure OBT ​NORCCAP单次筛查研究将20,780例50-64岁男性与女性参与者分为三组，一组仅接受软式乙状结肠镜检查，一组接受软式乙状结肠镜加FlexSure OBT（一种免疫化学法便潜血检查）
s218 Sentence Overall, the details of growth rates of adenomas and cancer are unknown; most likely there is a broad spectrum of growth patterns, including formation and spontaneous regression of adenomas 总体上看，腺瘤的生长速度和癌症之间的相关性不明确，很可能存在一个广谱生长模式，包括腺瘤的形成和自发退化
s219 Sentence The authors focused, however, on RR (i.e., RR of missing an advanced neoplasm) as the outcome, instead of absolute risk of such neoplasms, which is substantially lower in women 文章的主要结局为RR（即漏诊高级别瘤变的相对风险），而未以此类肿瘤的绝对风险作为主要结局，因女性的结直肠癌绝对风险显著低于男性
s220 Sentence The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families ​NCI网站提供癌症、临床试验的在线信息，及其他为癌症患者及其家人提供支持和资源网站或机构的联系方式
s221 Sentence This potential, along with the challenges of detecting flat lesions, may partially account for recent reports of a colonoscopy's lesser protective effect in the right colon compared to the left 恶变可能加上检测扁平状病变的难度均可能导致了近年来报道的结肠镜对右半结肠的保护作用不如左半结肠
s222 Sentence For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time ​如您需了解更多信息，美国居民可致电美国国家癌症研究所（NCI）癌症信息免费服务热线1-800-4-CANCER（1-800-422-6237），周一-周五，东部时间上午8:00-下午8:00
s223 Sentence In another study, 21,805 asymptomatic patients received iFOBT based on one stool sample collected by patients following the kit instructions on the day of or the day before the colonoscopy ​另一项研究中，21,805例无症状患者在结肠镜前一天或当天接受一次便标本iFOBT检测，采集和分析过程依据试剂盒说明
s224 Sentence However, the histologic and molecular characteristics of some serrated lesions suggest possibly important malignant potential (mutations in the BRAF gene may be an early step toward carcinogenesis in serrated polyps) 但一些锯齿状病变的组织学与分子学特征提示存在重要的恶变可能（BRAF基因突变可能是锯齿状息肉癌变的早期过程）
s225 Sentence One study found that reducing the cut-point from the standard 100 ng/mL to 50 ng/mL increased the detection of advanced adenomas but had little impact on the detection of cancer 一项研究发现将阈值从100 ng/mL降低到50 ng/mL会增加高级别腺瘤的检出率，但几乎不影响癌症检出率
s226 Sentence Among the groups that have a high incidence of CRC are those with hereditary conditions, such as familial adenomatous polyposis and hereditary nonpolyposis CRC (inherited in an autosomal dominant manner) CRC发病率较高的人群为有遗传性疾病的人群，例如家族性腺瘤性息肉病及遗传性非息肉性CRC（常染色体显性遗传）
s227 Sentence Based on case-control data about sigmoidoscopy, noted above, it has been speculated in the past that protection for the right colon might be similar to that found for the left colon 根据上文乙状结肠镜病例对照数据，发现既往对右半结肠的保护作用可能与左半结肠相似
s228 Sentence A combination of FOBT and sigmoidoscopy might increase the detection of lesions in the left colon (compared with sigmoidoscopy alone) while also increasing the detection of lesions in the right colon ​FOBT联合乙状结肠镜检查可能增加左半结肠病变检出率（与单行乙状结肠镜相比），同时也增加右半结肠检出率
s229 Sentence Until there are more reliable results from RCTs, it may be prudent to expect an approximately 60% to 70% CRC mortality reduction, based on consideration of these studies and other data 如无更多可靠的RCT结果，可根据这些研究及其他数据谨慎估计得CRC死亡率降低约60%-70%
s230 Sentence Long-term utilization of CTC will depend on several issues including the frequency of follow-up exams that would be needed to detect smaller lesions that were undetected and may grow over time 长期CTC使用情况需考虑几个问题，包括对初始未检出、但可能随着时间逐渐生长的较小病变的随访检查频率
s231 Sentence From the trials with nonrehydrated slides (Funen and Nottingham), the PPV was 5.0% to 18.7%, while the PPV in the trials using rehydrated slides (Goteborg and Minnesota) was 0.9% to 6.1% 使用非再水化涂片法的试验（菲英岛与诺丁汉试验）发现PPV为5.0%-18.7%，而使用再水化涂片的试验（哥德堡与明尼苏达试验）PPV为0.9%-6.1%
s232 Sentence The RR of CRC death in the gFOBT arm was 0.87 (95% CI, 0.8–0.95), and the RR of non-CRC death in the gFOBT group was 1.02 (95% CI, 1.00–1.04; P = .015) gFOBT组CRC死亡相对风险为0.87（95%CI，0.8-0.95），gFOBT组非CRC死亡相对风险为1.02（95%CI，1.00-1.04；P=0.015）
s233 Sentence Some part of the reduction may have been attributed to chance detection of cancer by colonoscopies; rehydration of guaiac test slides greatly increased positivity and consequently increased the number of colonoscopies performed 死亡率降低部分归因于偶因结肠镜检出癌症，愈创木脂检测涂片再水化显著提高了阳性率，并增加了行结肠镜的次数
s234 Sentence There was no reduction in all-cause mortality in either screened arm (RR, 1.00; 95% CI, 0.99–1.01 for the annually screened arm; and RR, 0.99; 95% CI, 0.98–1.01 for the biennially screened arm) 但这两组的全因死亡率均未降低（每年筛查一次组RR，1.00；95% CI，0.99–1.01；每2年筛查一次组RR，0.99；95% CI，0.98–1.01）
s235 Sentence The larger study found that 8.6% of patients had an extracolonic finding of at least moderate importance, while 24% of patients in the smaller study required some evaluation for an extracolonic finding 该大型研究发现有结肠外异常的患者中8.6%的异常具有至少中等重要性，小型研究发现有结肠外异常的患者中24%患者需要进一步评估
s236 Sentence The English trial allocated approximately 76,000 individuals to each arm. Those in the screened arm were offered nonrehydrated gFOBT testing every 2 years for three to six rounds from 1985 to 1995 ​英国试验共对76,000例参与者分组，对筛查组患者进行非再水化gFOBT检测，每2年一次，从1985-1995年共3-6次
s237 Sentence Patients must take laxatives to clean the colon before the procedure, and the colon is insufflated with air (sometimes carbon dioxide) by insertion of a rectal tube just prior to radiographic examination 患者在检查前必须进行肠道准备，检查前插入直肠管，对结肠进行空气充气（有时也用二氧化碳）
s238 Sentence Clinically significant complications requiring medical intervention were rare (0.1%) consisting of five perforations, 13 episodes of bleeding, 22 cardiovascular events, and 11 other events over the entire population of 50,148 screened persons 在全部50,148例被筛查者中，需干预的有临床意义的并发症十分罕见（0.1%），包括5例穿孔、13例出血、22例心血管事件和11例其他事件
s239 Sentence In a population-based study from Germany, data were obtained from administrative records and medical records; 1,688 case patients (with CRC) were compared with 1,932 participants (without CRC), aged 50 years or older 一项德国人群研究从管理记录与病历记录中收集数据，对大于等于50岁的1,688例患者（有CRC）和1,932例参与者（无CRC）进行比较
s240 Sentence This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about colorectal cancer screening. It is intended as a resource to inform and assist clinicians who care for cancer patients ​本PDQ癌症信息总结为医疗专业人士提供综合性、经同行审核的结直肠癌筛查相关循证信息，旨在教育并帮助为癌症患者提供医疗服务的临床医师
s241 Sentence Fecal occult blood levels were measured by two automated iFOBT tests according to the manufacturer’s instructions (RIDASCREEN Haemoglobin and RIDASCREEN Haemo-/Haptoglobin Complex, r-biopharm, Bensheim, Germany) following clinical procedures and blinded to colonoscopy results 在中心实验室，检查中心送来的冷冻便标本经过平均4天的解冻后，根据生产商的说明，进行2次全自动iFOBT检测便潜血水平（RIDASCREEN Haemoglobin与RIDASCREEN Haemo-/Haptoglobin Complex，r-biopharm，Bensheim，Germany），行结肠镜时并不知晓便潜血结果
s242 Sentence Stool DNA testing was recently assessed in a prospective study of asymptomatic persons who received colonoscopy, three-card FOBT (Hemoccult II), and stool DNA testing based on a panel of markers assessing 21 mutations 最近一项前瞻性研究纳入了无症状患者，评估了结肠镜、三卡FOBT（Hemoccult II）与21种突变标志物的粪便DNA检测的作用
s243 Sentence A study of 21,794 asymptomatic persons (72% were men) who had both colonoscopy and fecal immunochemical testing (FIT) for occult blood compared the detection of right-sided cancers as triggered by different test results 一项研究对21,794例无症状参与者（男性比例72%），这些参与者均曾行结肠镜和免疫化学法便潜血检查（FIT），该研究比较了不同方法检出右半结肠癌的有效性
s244 Sentence Based on solid evidence, screening for colorectal cancer (CRC) reduces CRC mortality, but there is little evidence that it reduces all-cause mortality, possibly because of an observed increase in other causes of death 可靠证据显示结直肠癌（CRC）的筛查降低CRC死亡率，但鲜有证据证明筛查降低全因死亡率，可能是其他原因死亡率增加所致
s245 Sentence Unknowns from the study include the following for either OC or CTC: the number of detected polyps that would have progressed to invasive cancer, and the number of people harmed by the screening process 该研究中无论OC或CTC未阐述清楚的问题包括：可能会进展为浸润性肿瘤的息肉数据，以及因筛查给检查者带来伤害的数据
s246 Sentence In another study, 59% of 111 symptomatic patients referred for clinical colonoscopy in a Swedish hospital between June 1998 and September 1999 were found to have moderate or major extracolonic conditions on CT colonography 另一项研究中，在1998年6月到1999年9月之间共111例有症状的患者到一家瑞典医院进行结肠镜检查，其中59%的患者的CT结肠成像显示出轻度或重度结肠外异常
s247 Sentence By tagging feces with iodinated contrast material ingested during several days prior to the procedure, investigators in one study were able to detect lesions larger than 8 mm with 95% sensitivity and 92% specificity 操作前几天，服用含碘对比剂，消化后标记粪便，通过这种方式研究者可检出直径大于8mm的病变，敏感性为95%，特异性为92%
s248 Sentence Of 109 people with at least one adenoma or cancer greater than or equal to 10 mm, 98 (90%) were detected by CTC (referring everyone with a CTC lesion of 5 mm or greater) 在109例至少有1枚直径大于等于10mm的腺瘤或癌症患者中，98例（90%）是经CTC发现（这些参与者的CTC病变均显示为大于等于5mm）
s249 Sentence Detection rates among gastroenterologists (mean number of lesions per patient screened, 0.10–1.05; range of the percentage of patients with adenomas, 9.4%–23.7%) and the times to withdraw (3.1–16.8 minutes for procedures not including polyp removal) 消化科医师筛查的每例患者病变平均数为0.10-1.05个，有腺瘤的患者比例在9.4%-23.7%，撤结肠镜时间为3.1-16.8分钟（不包括切除息肉）
s250 Sentence Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary ​编委会评价已发表文章的证据强度、决定是否应纳入本总结并达成共识之后对总结进行更新
s251 Sentence There are no data on the effect of other screening interventions (i.e., fecal occult blood test combined with sigmoidoscopy, barium enema, colonoscopy, computed tomographic colonography, and stool DNA mutation tests) on mortality from colorectal cancer 尚无其他筛查方式（例如，便潜血检查联合乙状结肠镜、钡灌肠、结肠镜、CT结肠成像和便DNA突变检测）对结直肠癌所致死亡率的作用相关数据
s252 Sentence From 2006 to 2010, CRC incidence declined by 3.7% per year among adults aged 50 years and older. However, in adults younger than 50 years, CRC incidence rates have been increasing by 1.8% per year 2006-2010年，50岁以上成年人中CRC发病率每年降低3.7%，但年龄低于50岁的成年人中CRC发病率每年增加1.8%
s253 Sentence These are the Norwegian Colorectal Cancer Prevention (NORCCAP) trial; the Telemark trial in Norway; the United Kingdom trial; the SCORE trial in Italy; and the U.S. Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial 这些试验包括挪威结直肠癌预防试验（NORCCAP），挪威Telemark试验，英国试验，意大利SCORE试验和美国前列腺癌、肺癌、结直肠癌与卵巢癌（PLCO）筛查试验
s254 Sentence Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches ​本总结所引用的一些参考文献有证据等级评估，旨在帮助读者评估使用某种干预或方法的证据强度
s255 Sentence The Danish trial in Funen, Denmark, entered approximately 31,000 individuals into two arms, in which individuals in the screened arm were offered nonrehydrated gFOBT testing every 2 years for nine rounds over a 17-year period ​在丹麦菲英岛开展的试验共招募31,000例参与者分为2组，筛查组的参与者每2年接受一次非再水化gFOBT筛查，17年共筛查9次
s256 Sentence At the same time, the existence of very flat or depressed lesions (depressed lesions are very uncommon but are highly likely to contain cancer) means that endoscopists will want to pay increasing attention to this problem 同时，极扁平或凹陷病变（凹陷病变极为罕见，但很可能有癌成分）的出现使得内镜医师将越来越重视扁平状病变
s257 Sentence The Minnesota trial randomly assigned 46,551 men and women aged 50 to 80 years to one of three arms: colorectal cancer screening with guaiac-based, rehydrated FOBT every year (15,570), every 2 years (15,587), or control (15,394) 明尼苏达州试验将46,551例50-80岁男性与女性分为3组：愈创木脂再水化便潜血法筛查结直肠癌每年一次组（15,570）、每2年一次组（15,587）及对照组（15,394）
s258 Sentence Suspected abnormalities involved kidney (34), chest (22), liver (8), ovary (6), renal or splenic arteries (4), retroperitoneum (3), and pancreas (1); however, the extent to which these findings will contribute to benefits or harms is uncertain 可疑的异常包括肾脏（34）、胸腔（22）、肝脏（8）、卵巢（6）、直肠或脾动脉（4）、腹膜后（3）与胰腺（1），但这些异常发现对患者有益还是有害的程度尚不确定
s259 Sentence The Swedish trial in Goteborg enrolled all 68,308 citizens in the city born between 1918 and 1931 who were aged 60 to 64 years and randomly assigned them to screening and control groups of nearly equal size 在瑞典哥德堡市进行的试验招募了全城1918-1931年期间出生的60-64岁市民共68,308人，将这些市民随机分入筛查组与对照组，两组人数相等
s260 Sentence This trial demonstrated an 18% reduction in CRC mortality at 10 years of follow-up, 15% at 13 years of follow-up (RR, 0.85; 95% CI, 0.73–1.00), and 11% at 17 years of follow-up (RR, 0.89; 95% CI, 0.78–1.01) 该试验发现随访10年后CRC死亡率降低18%，随访13年CRC死亡率降低15%（RR，0.85；95%CI，0.73-1.00），随访17年CRC死亡率降低11%（RR，0.89；95%CI，0.78-1.01）
s261 Sentence This study suggests that virtual colonoscopy might be an acceptable screening or surveillance test for persons with a high risk of CRC, but this cross-sectional study does not address outcome or frequency of testing in high-risk persons 该研究提出虚拟结肠镜作为CRC高危人群的筛查或监测方法是合理的，但该横断面研究未提供高危人群的结局或检查频率数据
s262 Sentence With follow-up through 30 years, there was a sustained reduction in CRC mortality of 32% in the annually screened arm (RR, 0.68; 95% CI, 0.56–0.82) and 22% in the biennially screened arm (RR, 0.78; 95% CI, 0.65–0.93) 随访30年发现每年筛查一次组的CRC死亡率持续降低（RR，0.68；95% CI，0.56–0.82），每2年筛查一次组的CRC死亡率亦持续降低（RR，0.78；95% CI，0.65–0.93）
s263 Sentence Potential false-positive test results due to an increased risk of upper GI bleeding are of concern with FOBT testing and pretest protocols, therefore; low-dose aspirin regimens should be discontinued for a week or more prior to FOBT FOBT检测与预试验方案存在上消化道出血导致假阳性结果的风险，故进行FOBT检测前低剂量阿司匹林需至少停药1周
s264 Sentence Important information that was not reported includes the treatment of CRC cases by stage and by arm and the extent of CRC screening in each arm by FOBT, sigmoidoscopy, or colonoscopy after the completion of the trial protocol 未报道的重要信息包括按不同分期治疗CRC患者，以及每组除试验方案之外使用FOBT、乙状结肠镜或结肠镜进行CRC筛查的强度
s265 Sentence Data from the Danish trial indicate that while the cumulative incidence of CRC was similar in the screened and control groups, a higher percentage of CRCs and adenomas were Dukes A and B lesions in the screened group 丹麦试验数据表明，尽管筛查组与对照组的CRC累积发病率很相似，但筛查组DukesA期与B期CRC与腺瘤比例更高
s266 Sentence In total, there were 721 CRCs (152 Dukes D, 184 Dukes C) in the screening group and 754 CRCs (161 Dukes D, 221 Dukes C) in the control group, with an incidence ratio of 0.96 (95% CI, 0.86–1.06) 筛查组共有721例CRC（152例Dukes D期，184例Dukes C期），对照组754例CRC（161例Dukes D期，221例Dukes C期），发病比为0.96（95%CI，0.86-1.06）
s267 Sentence However, because the definition of flat or nonpolypoid was height less than one-half of the diameter, it is likely that many lesions classified as nonpolypoid in this study would be routinely found and described by U.S. endoscopists as sessile 因为扁平状或非息肉样病变定义为高度小于直径的一半，很可能该研究中很多非息肉样病变正常情况下会被美国内镜医师描述为无蒂病变
s268 Sentence Both studies were conducted in prepaid health plans and suggested a significantly decreased risk (70%–90%) of fatal cancer of the distal colon or rectum among individuals with a history of one or more sigmoidoscopic examinations compared with nonscreened patients 两项研究的检查均纳入预付医疗保险，结果发现相较于未行筛查的参与者，至少进行一次乙状结肠镜筛查的参与者远端结肠或直肠致死性癌症风险显著降低（70%-90%）
s269 Sentence The prevalence of advanced proximal neoplasia is increased in patients with a villous or tubulovillous adenoma distally and is also increased in those aged 65 years or older with a positive family history of CRC and with multiple distal adenomas 有绒毛状或绒毛管状腺瘤的患者或年龄大于等于65岁且有CRC家族史或多发远端腺瘤家族史的患者中近端高级别瘤变的患病率增加
s270 Sentence For these iFOBTs, sensitivity for advanced neoplasms was notably higher with the use of low-dose aspirin while specificity was only slightly reduced, suggesting that there might be an advantage to aspirin use to increase sensitivity without much decrease in specificity 这些iFOBT检测法对高级别上皮内瘤变的敏感性与阿司匹林用药情况相关，对低剂量阿司匹林用药者的敏感性显著高于非用药者，而伴随着特异性略微降低，提示阿司匹林用药可增加敏感性，同时并不显著降低特异性
s271 Sentence Specificities were 85.7% (95% CI, 80.2–90.1%) for users compared with 89.2% (95% CI, 87.6%–90.7%) for nonusers and 85.7% (95% CI, 80.2%–90.1%) for users compared with 91.1% (95% CI, 89.5%–92.4%) for nonusers ( P = .13 and P = .01, respectively) 一种检测对阿司匹林用药者和非阿司匹林用药者的特异性分别为85.7%（95%CI，80.2-90.1%）与89.2%（95%CI，87.6%-90.7%），另一种检测对这两类人群的特异性分别为85.7%（95%CI，80.2%-90.1%）与91.1%（95%CI，89.5%-92.4%）（分别有P=0.13，P=0.01）
s272 Sentence More common conditions associated with an increased risk include a personal history of CRC or adenomas; first-degree relative with CRC; a personal history of ovarian, endometrial, or breast cancer; and a personal history of long-standing chronic ulcerative colitis or Crohn colitis 增加患病风险的更常见疾病包括CRC或腺瘤病史、一级亲属患CRC、卵巢癌、子宫内膜癌或乳腺癌病史、长期慢性溃疡性结肠炎或克罗恩病史
s273 Sentence Subsequent analyses by the Minnesota investigators using mathematical modeling suggested that for 75% to 84% of the patients, mortality reduction was achieved because of sensitive detection of CRCs by the test; chance detection played a modest role (16%–25% of the reduction) 明尼苏达州研究者使用数学模型进行的后续分析发现对于75%-84%的患者，死亡率降低的原因是该筛查法对检出CRC较为敏感，而偶因结肠镜检出癌症只起小部分作用（占降低比例的16%-25%）
s274 Sentence Patients with large adenomas (≥10.0 mm) or small adenomas (&lt;10.0 mm) in the distal colon were more likely to have advanced proximal neoplasia than were patients with no distal adenomas (OR, 3.4; 90% CI, 1.8–6.5 and OR, 2.6; 90% CI, 1.7–4.1, respectively) 远端结肠有较大腺瘤（直径≥10.0mm）或小腺瘤（<10.0mm）的参与者的高级别近端肿瘤发病率大于无远端腺瘤参与者（分别有OR，2.4；90%CI，1.8-6.5；OR，2.6；90%CI，1.7-4.1）
s275 Sentence When the median follow-up was extended to 19.5 years, there was a 9% reduction in CRC mortality (RR, 0.91; 95% CI, 0.84–0.98) but no reduction in CRC incidence (RR, 0.97; 95% CI, 0.91–1.03), or death from all causes (RR, 1.00; 95% CI, 0.99–1.02) 随访时间中位数延长至19.5年，CRC死亡率降低9%（RR，0.91；95%CI，0.84-0.98），但CRC发病率（RR，0.97；95%CI，0.91-1.03）或全因死亡率并没有降低（RR，1.00；95%CI，0.99-1.02）
s276 Sentence In effect, measures that reduce the incidence and prevalence of adenomas may result in a subsequent decrease in the risk of CRCs; however, some CRC mortality may be caused by fast-growing lesions and even lesions that do not pass through an adenomatous phase 降低腺瘤发病率与患病率可能会显著降低CRC风险。但一些CRC患者的死亡可能是病变生长过快所致，这些病变很可能并未经过腺瘤阶段
s277 Sentence Fifteen percent of patients in an Australian series of 100 patients, referred for colonography because of symptoms or family history, were found to have extracolonic findings, and 11% of the patients needed further medical workups for renal, splenic, uterine, liver, and gallbladder abnormalities 一项澳大利亚病例分析研究共纳入100例患者，这些患者因出现症状或有家族史而接受结肠成像检查，发现其中11%的患者需进行肾脏、脾脏、子宫、肝脏和胆囊异常检查
s278 Sentence There was an overall 28% relative reduction in CRC mortality (RR, 0.72; 95% CI, 0.65–0.80), an 18% relative reduction in CRC incidence (RR, 0.82; 95% CI, 0.73–0.91), and a 33% relative reduction in the incidence of left-sided CRC (RR, 0.67; 95% CI, 0.59–0.76) CRC死亡率相对降低28%（RR，0.72；95%CI，0.65-0.80），CRC发病率相对降低18%（RR，0.82；95%CI，0.73-0.91），左半CRC发病率相对降低33%（RR，0.67；95%CI，0.59-0.76）
s279 Sentence In other words, it is impossible to determine the reason for the dramatically different results on the right side compared to the left side, which are either the result of physician-related and patient-related factors or are the result of the biology of cancer 换言之，无法判断右半结肠与左半结肠的检出率具有如此戏剧性差异的原因，也许与医师因素、患者因素相关，也可能与癌症生物学行为相关
s280 Sentence Examiners whose mean withdrawal time was 6 minutes or more had higher detection rates than those with mean withdrawal times of less than 6 minutes (28.3% vs 11.8%; P &lt; .001 for any neoplasia) and (6.4% vs 2.6%; P &lt; .005 for advanced neoplasia) 平均撤镜时间为6分钟或6分钟以上的检查医师的检出率大于撤镜时间小于6分钟的医师（对任何瘤变的检出率分别为28.3%与11.8%；P<0.001；对高级别瘤变的检出率分别为6.4%与2.6%；P<0.005）
s281 Sentence In a colonoscopic study of 3,121 predominantly male U.S. veterans (mean age: 63 years), advanced neoplasia (defined as an adenoma that was ≥10.0 mm in diameter, a villous adenoma, an adenoma with high-grade dysplasia, or invasive cancer) was identified in 10.5% of the individuals 一项研究对3,121例美国退伍军人（男性为主，平均年龄63岁）进行结肠镜检查，其中10.5%的参与者被检出肿瘤（定义为直径≥10.0mm的腺瘤、绒毛状腺瘤、高级别不典型增生腺瘤或侵袭性癌症）
s282 Sentence Conducted in a blinded way with prestated hypotheses and analyses, the study found that among 4,404 patients, the DNA panel had a sensitivity for CRC of 51.6% (for all stages of CRC) versus 12.9% for Hemoccult II, while the false-positive rates were 5.6% and 4.8%, respectively 该研究通过提出假说、进行分析的设盲方式进行，，该研究发现在4,404例患者中，DNA检测对CRC的敏感性为51.6%（对各期CRC），而Hemoccult II为12.9%，两种检测方法的假阳性率分别为5.6%与4.8%
s283 Sentence A large, paired-design study was conducted by the American College of Radiology Imaging Network group, with 2,531 average-risk people (prevalence of polyps or cancer greater than or equal to 10 mm, 4%; mean age about 58 years) screened with both CT colonography and optical colonoscopy (OC) ​美国放射学会成像网络组进行了一项大型配对设计研究，对2,531例中危参与者（直径≥10mm的息肉或癌症患病率为4%，平均年龄58岁）进行CT结肠成像和光学结肠镜（OC）筛查
s284 Sentence A systematic review to evaluate the comparative diagnostic performance of gFOBT and iFOBT in the context of a decision to introduce screening for CRC in the United Kingdom, included 33 studies evaluating gFOBT and 35 studies evaluating iFOBT, including nine that evaluated both gFOBT and iFOBT ​一项系统性综述对比评估了gFOBT与iFOBT的诊断性能，以决定是否在英国引入CRC筛查，该综述共纳入33项gFOBT评估研究与35项iFOBT评估研究，其中9项研究评估了二者
s285 Sentence Collection details vary somewhat for different tests, but typically involve collection of as many as three different specimens on 3 different days, with small amounts from one specimen smeared by a wooden stick on a card with two windows or otherwise placed in a specimen container 采集细节因检测方式不同而异，但通常需要在不同的3天采集共至少3次标本，用小木棒在含有2个检测窗的检测卡上涂抹少量标本，或放在标本容器中
s286 Sentence They studied 15 colonoscopists on faculty at one university and showed, during the years 2000 to 2009, a wide variation in detection rate for proximal serrated polyps, ranging (per colonoscopy) from 0.01 to 0.26, suggesting that many proximal serrated lesions may be missed on routine exam 该研究对一所大学的15名结肠镜医师进行研究，发现2000-2009年之间，近端锯齿状息肉的检出率具有较大差异，从0.01到0.26（每次结肠镜检查），表明常规检查中很可能漏诊了很多近端锯齿状病变
s287 Sentence In a study in which endoscopists used high-resolution white-light endoscopes, flat or nonpolypoid lesions were found to account for only 11% of all superficial colon lesions, but they were about 9.8 times as likely to contain cancer ( in situ neoplasia or invasive cancer) compared with polypoid lesions 一项研究中，医师使用高分辨率白光内镜进行检查，结果发现扁平状或非息肉样病变仅占所有浅表结肠病变的11%，但这些病变相比于息肉样病变，包含癌成分（原位癌或侵袭性癌）的可能性则升至9.8倍
s288 Sentence Sigmoidoscopy detects lesions in the left colon directly but detects lesions in the right colon only indirectly when a positive sigmoidoscopy (that may variously be defined as a finding of advanced adenoma, any adenoma, or any polyp) is used to trigger a colonoscopic examination of the whole colon 乙状结肠镜对左半结肠病变的检查更加直接。如果乙状结肠镜结果为阳性（不同试验对阳性的定义不同，包括高级别腺瘤、任何腺瘤或任何息肉等），则需对全结肠行结肠镜检查
s289 Sentence This trial demonstrated that annual FOBT screening decreased mortality from colorectal cancer (CRC) by 33% after 18 years of follow-up (relative risk [RR], 0.67; 95% confidence interval [CI], 0.51–0.83, compared with the control group) and that biennial testing resulted in a 21% relative mortality reduction (RR, 0.79, 95% CI 0.62–0.97) 18年随访结果显示，该试验每年FOBT筛查随访可降低结直肠癌（CRC）死亡率33%（与对照组相比相对风险[RR]，0.67；95%置信区间[CI]，0.51-0.83），每2年筛查一次使相对死亡率降低21%（RR，0.79，95%CI，0.62-0.97）
s290 Sentence At the cut-point recommended by the manufacturer, sensitivities for the two tests were 70.8% (95% CI, 48.9%–87.4%) for users compared with 35.9% (95% CI, 28.9%–43.4%) for nonusers and 58.3% (95% CI, 36.6%–77.9%) for users compared with 32% (95% CI, 25.3%–39.4%) for nonusers ( P = .001 and P = .01, respectively) 根据生产商推荐的阳性阈值，一种检测对阿司匹林用药者和非阿司匹林用药者的敏感性分别为70.8%（95% CI，48.9%-87.4%）与35.9%（95%CI，28.9%-43.4%），另一种检测对这两类人群的敏感性分别为58.3%（95%CI，36.6%-77.9%）与32%（95%CI，25.3%-39.4%）（分别有P=0.001，P=0.01）
s291 Sentence In one study, 2,188 patients scheduled for colonoscopy because of an elevated risk due to personal or family history of colorectal neoplasm, positive gFOBT result, change in bowel habits, anemia, abdominal pain with weight loss, or anal symptoms were invited to participate in a comparative assessment of iFOBT against colonoscopy findings ​一项研究对2,188例患者安排结肠镜检查，检查理由包括有结肠肿瘤病史或家族史、gFOBT结果阳性、排便习惯改变、贫血、腹痛伴体重下降或肛门不适症状，邀请这些患者参与iFOBT与结肠镜的对比性评估研究
s292 Sentence While specificity for detection of polyps is homogeneously high in many studies, sensitivity can vary widely. These variations are attributable to a number of factors including characteristics of the CT scanner and detector, width of collimation, mode of imaging (two dimensional [2-D] vs 3-D and/or "fly-through"), and variability in expertise of radiologists 虽然很多研究中息肉检查的特异性均较高，但敏感性则有很大差异，原因较为复杂，包括CT扫描仪的特点、检查者因素、准直宽度、成像模式（二维[2D]与3D和（或）“漫游技术”）及放射科医师的经验因素
s293 Sentence Of the 43,042 participants aged 50 to 66 years, advanced neoplasia was detected in 5.9% (5.7% among women with a family history of CRC, 4.3% among women without a family history of CRC, 12.2% among men with a family history of CRC, and 8.0% among men without a family history of CRC) 年龄在50-66岁的43,042例参与者中，高级别瘤变的发生率为5.9%（在有CRC家族史的女性中该比例为5.7%，有CRC家族史的男性中该比例为12.2%，无CRC家族史的男性中该比例为8.0%）
s294 Sentence Fifteen percent of patients in an Australian series of 100 patients, referred for colonography because of symptoms or family history, were found to have extracolonic findings, and 11% of the patients needed further medical workups for renal, splenic, uterine, liver, and gallbladder abnormalities. Other areas of extracolonic findings include the chest, ovary, and pancreas 一项澳大利亚病例分析研究共纳入100例患者，这些患者因出现症状或有家族史而接受结肠成像检查，发现其中15%的患者需进行肾脏、脾脏、子宫、肝脏和胆囊异常检查
s295 Sentence All patients provided one stool sample taken within a week before colonoscopy preparation, which was collected according to instructions in a container that was kept refrigerated or frozen until rendered to the clinic on the day of colonoscopy, and the patients agreed to complete a standard questionnaire regarding the use of analgesics and low-dose aspirin (for prevention of cardiovascular disease) 所有患者均在结肠镜准备前1周提供1份便标本，采集过程依据容器标签上的说明，标本冷冻保存，结肠镜当日交给检查中心
s296 Sentence Even if it is not possible to determine which reasons may be responsible for the right side versus the left side difference, the findings beg the question, “What is the degree of mortality reduction from colonoscopy?” While a figure of 90% is sometimes cited as the degree of mortality reduction, the question will not be properly answered until the European study is completed ​尽管无法判断导致右半结肠与左半结肠病变检出率具有较大差异的原因，但该研究结果也提出了下列问题，“结肠镜降低死亡率的作用有多大”。虽然有些文章引用了90%作为死亡率降低数据，但直至欧洲研究完成，该问题才有了适当答案
s297 Sentence The proportion of examinations in which adenomatous polyps were detected by barium enema was related to the size of the adenoma ( P = .009); the rate was 32% for colonoscopic examinations in which the largest adenomas detected were no larger than 5 mm, 53% for those in which the largest adenomas detected were 6 mm to 10 mm, and 48% for those in which the largest adenomas detected were larger than 10 mm 钡灌肠检出的腺瘤性息肉比例与息肉大小相关（P=0.009）；息肉最大直径不超过5mm时结肠镜检出的腺瘤性息肉比例为32%，息肉最大直径为6mm-10mm时腺瘤性息肉检出率53%，息肉最大直径大于10mm时腺瘤性息肉检出率为48%